Access to medicines

WTO sacrifices access to medicines before Hong Kong ministerial meeting

"... it seems that the WTO has decided to sacrifice access to medicines before the Hong Kong meeting, settling for inadequate measures simply to get it off the agenda," said 't Hoen.

Hong Kong - The World Trade Organization (WTO) has sacrificed its chance to ensure adequate generic production of essential medicines, said international aid organization Médecins Sans Frontières (MSF) today.

In the rush to close the medicines issue before the ministerial meeting in Hong Kong, the WTO agreed to amend the TRIPS Agreement last week in Geneva, with the intention of easing the supply of generic medicines. However, MSF, other public health groups, and drug manufacturers have long viewed this amendment (called the 'August 30th Decision') as overly cumbersome and inefficient because it ignores the economic reality of drug production.

The amendment's burdensome drug-by-drug, country-by-country decision-making process discourages economies of scale and slows down price reductions.

In particular, the amendment will impact generic production of newer drugs that have been patented relatively recently, such as "second-line" AIDS medicines. MSF currently treats about 57,000 people with HIV/AIDS in 29 countries. Over time, more and more of these patients will develop resistance and inevitably need to replace their first-line regimen with second-line drugs - these drugs cost five to 30 times more than the first-line.

"Today, MSF is facing steeply increasing costs to provide newer AIDS medicines to patients in our projects. Providing just 10% of patients with second-line drugs could nearly quadruple what a program has to spend on drugs alone," according to Dr. Karim Laouabdia, Director of the MSF Campaign for Access to Essential Medicines.

Since the 'August 30th' measures were first agreed upon in 2003, only four countries have adopted them into their national laws - Canada, Norway, India, and just recently, China. On November 29, China issued an order implementing the August 30th decision with a reference to the 2001 Doha Declaration.

While implementation in these four countries is an encouraging indicator that governments are willing to use compulsory licenses to respond to public health problems, it is not at all clear that the system will actually work to achieve affordable generic production.

"There is a glaring lack of evidence that the measures proposed by the WTO would actually resolve the difficulties we are facing - not one patient has benefited from its use," said Ellen 't Hoen, Director of Policy Advocacy for the MSF Access Campaign. "Since 2003 we have tried to place drug orders under the 'August 30' decision. But these attempts have not yet been successful. We were urging WTO Members to demand such evidence before turning the 2003 decision into a permanent amendment to TRIPS.


In light of these concerns, MSF calls on the WTO to provide evidence by the end of 2006 demonstrating that the ('August 30') amendment to the TRIPS Agreement can effectively meet global needs for affordable generic medicines.